Individual
TERENCE F WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9630 S KOMENSKY AVE APT 210, OAK LAWN, IL 60453-3360
(929) 372-0380
Mailing address
9630 S KOMENSKY AVE APT 210, OAK LAWN, IL 60453-3360
(929) 372-0380
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AG04250063
IL
Other
Enumeration date
05/02/2025
Last updated
05/02/2025
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